Metal-on-metal hip resurfacing: advantages and disadvantages

Modern metal-on-metal resurfacing has recently gained popularity as an alternative to standard stemmed total hip arthroplasty. This study analyzed, from a literature review, the purported advantages and disadvantages of resurfacing with a comparison to standard hip arthroplasty. Advantages may include bone conservation on the femoral side with possible lower dislocation rates, more range-of-motion, more normal gait pattern, increased activity levels, increased ease of insertion with proximal femoral deformities or retained hardware, and straightforward revision. Possible disadvantages of resurfacing are increased difficulty to perform the procedure, increased acetabular bone stock loss, femoral neck fractures, and concerns about the effects of metal ions. Many of these issues will need further clarification by well-planned prospective studies and evaluation of longer-term outcomes.